The Diagnostic Sensitivity for Ulnar Neuropathy at the Elbow Is Not Increased by Addition of Needle EMG of ADM and FDI When Nerve Conduction Studies Are Normal

Introduction: The main objective of this study was to investigate whether electromyography (EMG) has additional value in the confirmation of the clinical diagnosis of ulnar nerve entrapment at the elbow (UNE) if nerve conduction studies (NCS) are normal.Methods: A prospective cross-sectional cohort observational study was conducted among patients with the clinical suspicion of UNE. A total of 199 arms were included, who were examined according to a standard neurophysiological protocol, i.e., NCS and EMG relevant to the ulnar nerve.Results: NCS were normal in 76 (38.2%) arms. No abnormal spontaneous muscle fiber activity was found with EMG in any of these cases. In 9 arms with normal NCS (11.8%), isolated abnormal MUAP configurations were found with EMG. Of these nine arms one UNE was diagnosed clinically, in which additional ultrasound and repeated NCS/EMG were negative. One had already been diagnosed with neuralgic amyotrophy and one with CTS. The other 6 arms had additional diagnostics which did not reveal an UNE.Conclusion: EMG as part of the standard neurophysiological protocol exclusively in the confirmation of the clinical diagnosis of UNE has limited added value if NCS are normal in a high prior-odds setting. However, removing EMG may prevent detecting concomitant and/or additional differential diagnoses

Predicting the Need for Biopsy to Detect Clinically Significant Prostate Cancer in Patients with a Magnetic Resonance Imaging–detected Prostate Imaging Reporting and Data System/Likert ≥3 Lesion: Development and Multinational External Validation of the Imperial Rapid Access to Prostate Imaging and Diagnosis Risk Score

Background: Although multiparametric magnetic resonance imaging (MRI) has highsensitivity, its lower specificity leads to a high prevalence of false-positive lesions requir-ing biopsy.Objective: To develop and externally validate a scoring system for MRI-detected ProstateImaging Reporting and Data System (PIRADS)/Likert 3 lesions containing clinically sig-nificant prostate cancer (csPCa).Design, setting, and participants: The multicentre Rapid Access to Prostate Imaging andDiagnosis (RAPID) pathway included 1189 patients referred to urology due to elevatedage-specific prostate-specific antigen (PSA) and/or abnormal digital rectal examination (DRE); April 27, 2017 to October 25, 2019.</p

LAMP ROBOT WITH MEMORY METAL DRIVES

A lamp robot that obeys verbal orders. The principle of the lamp is basically a combination of two new technologies : speech recognition and memory metal. The lamp can move in six directions, and the movements can be generated by extremely small memory metal elements with a total mass of about 3 grams. The temperature of the memory elements and thus also their shape can be remote controlled by a system which exists of a Personal Computer with a speech recognition card and a microphone, an interface with D/A and A/D-converter and amplifier and the lamp robot itself. Heating of the memory metal is achieved by direct resistance heating pulses from the interface. The position of each drive system is recorded continiously by miniature precision potentiometers and any desired intermediate position can be reached and kept by spoken commands. A fast transformation of the TiNi-elements and so short response times is achieved by the use of very thin flat rolled wire of 0.2 * 1.7 mm, produced by Memory Metal Holland in Enschede. This flat wire combines high recovery forces with much higher cooling rates than round wire. The lamp robot has been developed for and installed in "The House of the Future" in Rosmalen, The Netherlands, which gives a permanent exhibition of possible applications of new technologies in houses. A possible application is for use by disabled persons

Elevated uterine activity increases the risk of fetal acidosis at birth

Objective: The objective of the study was to assess the role of uterine activity on fetal outcome. Study Design: Intrauterine pressure (IUP) recordings from consecutive term singleton, vaginal deliveries collected between June 1, 1993, and July 1, 2004, were analyzed. One thousand four hundred thirty-three recordings were included. IUP data were obtained using HP 8040A and HP M1350 cardiotocographs. For each recording the uterine contraction curve was analyzed, and the following contraction parameters were determined: relaxation time; contraction duration, frequency, amplitude, and surface; Montevideo units; and active planimeter units and contraction frequency. IUP recordings and contraction parameters from deliveries ending with an umbilical artery pH of 7.11 or less were compared with those ending with an umbilical artery pH of 7.12 or greater. Statistical analyses were performed using Student's t test and logistic regression. Results: An umbilical artery pH 7.11 or less at birth is associated with significant more uterine activity during the first and second stage of labor. Conclusion: Increased uterine activity is significantly associated with a higher incidence of an umbilical artery pH of 7.11 or less

Evaluatie experiment 'beroepsopleiding gecombineerde leerwegen bol-bbl' (GLBB): Meting 2018

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